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A 64-Year-Old Lady Is Examined for a 2 Year Progression

Question 328

Multiple Choice

A 64-year-old lady is examined for a 2 year progression of gait abnormality. The patient feels wobbly and as though her feet are "trapped on the floor" when walking. Additionally, she has recently started having frequent urination and has wet herself a few times as a result of having trouble finding time to use the restroom. Due to her inability to focus, the patient stopped working six months ago. She has since lost interest in both her hobbies and social activities. No tremor, vision problems, headaches, nausea, or vomiting have been reported by her. There is a distant history of closed traumatic brain injury in the patient. Vital indicators are in the expected range. On physical examination, there is increased tone in the lower extremities and deep tendon reflexes. It's natural to feel vibration, discomfort, and light touch. The patient's gait is slow with small steps and a wide base.  CT scan of the head is shown below. A 64-year-old lady is examined for a 2 year progression of gait abnormality. The patient feels wobbly and as though her feet are  trapped on the floor  when walking. Additionally, she has recently started having frequent urination and has wet herself a few times as a result of having trouble finding time to use the restroom. Due to her inability to focus, the patient stopped working six months ago. She has since lost interest in both her hobbies and social activities. No tremor, vision problems, headaches, nausea, or vomiting have been reported by her. There is a distant history of closed traumatic brain injury in the patient. Vital indicators are in the expected range. On physical examination, there is increased tone in the lower extremities and deep tendon reflexes. It's natural to feel vibration, discomfort, and light touch. The patient's gait is slow with small steps and a wide base.  CT scan of the head is shown below.   Which of the following is the most likely diagnosis? A) Alzheimer disease B) Frontotemporal dementia C) Idiopathic Parkinson disease D) Major depressive disorder E) Normal pressure hydrocephalus F) Obstructive hydrocephalus G) Vitamin B<sub>12</sub> deficiency Which of the following is the most likely diagnosis?


A) Alzheimer disease
B) Frontotemporal dementia
C) Idiopathic Parkinson disease
D) Major depressive disorder
E) Normal pressure hydrocephalus
F) Obstructive hydrocephalus
G) Vitamin B12 deficiency

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